Priority Health CT Cervical Spine without contrast prior authorization requirements (2026)
What Priority Health generally requires to approve CT Cervical Spine without contrast (CPT 72125), for Commercial plans. Yes. Priority Health generally requires prior authorization for CT Cervical Spine without contrast (CPT 72125).
Medical-necessity criteria Priority Health generally applies
[NEEDS CLINICAL SPOT-CHECK] Prior authorization required for advanced diagnostic imaging (CT/MRI) in office/outpatient settings; Priority Health administers spine imaging review through eviCore via its Auth Request tool, following eviCore imaging guidelines.
How to submit
- Method: eviCore (Auth Request tool)
Sources & verification
- BindingSource — Radiology: Advanced diagnostic (Provider Manual).View
- BindingSource — Priority Health Provider Resources.View
Binding = the payer's own policy. Proxy = a public, evidence-based clinical guideline the payer mirrors. Portal-only = the binding criteria are confirmed in the administrator's portal. Always confirm against the payer for the member's specific plan. Last verified 2026-06-28.
Frequently asked questions
Does Priority Health require prior authorization for CT Cervical Spine without contrast?
Yes. Priority Health generally requires prior authorization for CT Cervical Spine without contrast (CPT 72125).
What does Priority Health require to approve CT Cervical Spine without contrast?
[NEEDS CLINICAL SPOT-CHECK] Prior authorization required for advanced diagnostic imaging (CT/MRI) in office/outpatient settings; Priority Health administers spine imaging review through eviCore via its Auth Request tool, following eviCore imaging guidelines. Always confirm against the current Priority Health policy.
How long does a Priority Health prior authorization take?
Turnaround varies by plan and submission method. Check the Priority Health portal for current timeframes.
Submitting CT Cervical Spine without contrast to Priority Health?
Praxigen checks your clinical note against these criteria before you submit and drafts a policy-cited appeal if it is denied. You review and submit; nothing is sent automatically.